What are the benefits of exercise during pregnancy?

Childbirth is among the most physically stressful challenges a woman ever faces. Regular exercise during pregnancy:

• strengthens muscles needed for labor and delivery
• helps reduce backaches, constipation, bloating, and swelling
• improves posture
• Gives you energy and improves your mood
• Lessens some of the discomforts of pregnancy
• Helps you feel less tired and sleep better.
• May help prevent gestational diabetes.

When should I start exercising?

Regular exercise is a very important part of a healthy lifestyle. If you haven’t been exercising most days of the week and are thinking about getting pregnant, now is a good time to start. The sooner you begin exercising, the better you will feel during and after your pregnancy.

A big mistake many women make is not starting an exercise program until the last 3 months of pregnancy, when they start childbirth classes. Some exercise can be harder to do during the last 3 months because your enlarged uterus and breasts change your center of gravity, affecting your balance. Also, hormonal changes make your joints looser. This makes it easier to develop spasms and injure yourself. Also, if you have not been exercising regularly until this point in pregnancy, even moderate exercise may decrease the oxygen supply to your baby. Simple walking may be the best exercise at this time of pregnancy.

Before you begin an exercise program, discuss it with your health care provider. Make sure you follow his or her advice on an exercise program that is right for you. If you are having problems with your pregnancy, you should not exercise. Exercise can affect the amount of oxygen your baby gets. Even light exercise might hurt a baby that already has problems with getting enough oxygen.

Which muscle groups are most important to exercise?

In addition to your heart, the 3 muscle groups you should concentrate on during pregnancy are the muscles of your abdomen, back, and pelvis.

• Strengthening your abdominal muscles will make it easier to support the increasing weight of your baby. You will also be able to 
push with more strength and more effectively during the last phase of delivering your baby.
• Strengthening back muscles and doing exercises to improve your posture will reduce the strain of pregnancy on your lower back. 
It will help prevent discomfort caused by poor posture.
• Strengthening pelvic muscles will allow your vagina to widen more easily during childbirth. This will help prevent urinary 
problems (leaking urine when you cough or sneeze) after delivery.

What kinds of exercise can I do?

Many old ideas about strenuous exercise during pregnancy have been disproved in recent years. The type and intensity of sports and exercise you participate in during pregnancy depend on your health and on how active you were before you became pregnant. This is probably not a good time to take up a new strenuous sport. If you were active before you became pregnant, however, there is no reason you cannot continue, within reason.

• Walking. If you did not do any exercise before becoming pregnant, walking is a good way to begin an exercise program.
• Tennis. If you are an active tennis player, you can probably continue to play unless you have special problems or feel unusually tired. Just be aware of your change in balance and how it affects rapid movement.
• Jogging. If you jog, you probably can continue as long as you feel comfortable doing it. Avoid becoming overheated and stop if you feel uncomfortable or unusually tired. Remember to drink plenty of water.
• Swimming. If you are a swimmer, you can continue to swim. Swimming is an excellent form of exercise. The water supports your weight while you tone and strengthen many different muscles. Scuba diving is not advised because of the risk of decompression sickness.
• Golf and bowling. Both of these sports are good forms of recreation. You will just have to adjust to your enlarged abdomen. Be careful not to lose your balance.
• Snow skiing, water skiing, and surfing. These sports can be dangerous because you can hit the ground or water with great force. Falling while traveling at fast speeds could harm your baby. Talk to your healthcare provider before participating in these activities.
• Climbing, hiking, and skiing above 10,000 feet. Elevations above 10,000 feet can deprive you and your baby of oxygen. This can cause premature labor. Avoid strenuous exercise at this altitude, especially if you normally live close to sea level. Walking or swimming may be OK but do not do exercises that cause make you short of breath or give you muscle cramps.
• Kegel exercises. Kegel exercises help strengthen your pelvic muscles and prepare them for childbirth. Your health care provider can tell you how to do these exercises.

What are the guidelines for exercising during pregnancy?

• Warming up and cooling down are very important. Start slowly and build up to more demanding exercises. Toward the end of an exercise session, gradually slow down your activity. Try working back through the exercises in reverse order.
• Regular exercise most days of the week is better for you than spurts of exercise followed by long periods of no activity. Moderate exercise for 30 minutes or more is recommended for most healthy women.
• Check your pulse during peak activity. Slow down your activity if your heart starts beating faster than the target range recommended by your health care provider. Don’t exceed a heart rate of 140 beats per minute. Exercise that is too strenuous may speed up the baby’s heartbeat to a dangerous level. In general, if you are able to carry on a conversation comfortably while exercising, your heart rate is probably within the recommended limits. Check to make sure.
• Don’t try to do too much. Remember that the extra weight you are carrying will make you work harder as you exercise. Stop right away if you feel tired, short of breath, or dizzy.
• Drink water often before, during, and after exercise to prevent dehydration. Take a break in your workout to drink more water if needed.
• Don’t participate in sports and exercise in which you might fall or be bumped.
• Be very careful with your back. Avoid positions and exercises that increase the bend in your back. They put extra stress on the stretched abdominal muscles and compress your spinal joints. Deep knee bends, full sit-ups, double leg raises, and straight-leg toe touches also may injure the tissues that connect your back joints and legs.
• After the first trimester, avoid doing exercises while you are lying on your back because it decreases the oxygen your baby gets from your blood.
• Your exercise program may need to change somewhat after 20 weeks of pregnancy because of your large stomach and possible problems with balance.
• Do not get overheated. Avoid outdoor exercise in hot, humid weather. Also avoid hot tubs, whirlpools, or saunas. Becoming overheated during pregnancy increases the baby’s temperature. If the baby’s temperature increases too much, it can affect the cells developing in the baby’s nervous system and brain.
• Do not exercise if you have an illness with a temperature of 100°F (37.8°C) or higher.
• Avoid jerky, bouncy, or high-impact motions that require jarring or quick changes in direction. Examples of such movements are those that can occur with contact sports, jump-roping, and trampoline jumping. These motions may cause back, abdominal, pelvic, and leg pain. They could also cause you to lose your balance.
• Wear a good-fitting and supportive bra to protect your enlarged breasts.
• Make exercise a part of your daily life. Daily tasks can double as exercise sessions if you do the following: Tighten your abdominal muscles when you are standing or sitting. Squat when you lift anything, whether it is light or heavy. Rotate your feet and ankles anytime your feet are elevated. Check your posture each time you pass a mirror. 

When should I stop exercising?

You should stop exercising and call your health care provider if you have any unusual symptoms, such as:

• Pain, including pelvic pain, uterine contractions, or chest pain
• Trouble walking
• Bleeding or fluid leaking from the vagina
• Faintness or dizziness
• An increase in shortness of breath
• Muscle weakness
• Pain in the calf of your leg
• Headaches when you exercise
• Irregular heartbeat (skipped beats or very rapid beats)
• You notice that the baby is moving less during or after exercise

Do not exercise when you are pregnant and have:

• Heart or lung disease
• An incompetent cervix
• More than 1 baby (such as twins)
• Vaginal bleeding or leaking of fluid from the vagina
• Placenta previa
• Premature labor
• Ruptured membranes
• Pre-eclampsia

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